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Shiferaw R, Yirgu R, Getnet Y. Evaluating the association between duration of breastfeeding and fine motor development among children aged 20 to 24 months in Butajira, Ethiopia: a case-control study. BMC Pediatr 2024; 24:216. [PMID: 38532394 DOI: 10.1186/s12887-023-04391-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 10/27/2023] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND A Suitable environment and proper child nutrition are paramount to a child's physical and mental development. Different environmental factors contribute to proper child development. Breast milk is an important source of nutrition during the early years of life and contains essential nutrients that are the building blocks for growth and development. OBJECTIVE To assess the association between the duration of breastfeeding and fine motor development among children aged 20 to 24 months living in Butajira, southern Ethiopia. METHOD Community-based case-control study design was employed among mother-child dyads of children aged 20 to 24 months in Butajira Southern Ethiopia. Children were screened for fine motor delay using the Denver II developmental screening and identified as cases and controls. A repeated visit was done to gather the rest of the information and 332 samples, 83 cases, and 249 controls were available and assessed. Epi-data version 4.4.2.1 software was used to prepare a data entry template, which was later exported to and analyzed using STATA version 14 statistical software. Finally, a Multivariable logistic regression model was used to adjust for confounders and estimate the independent effect of breastfeeding duration on fine motor development. RESULT We didn't find a significant association between the duration of breastfeeding from 21 to 24 months and fine motor delay compared to children who were breastfed less than 18 months[AOR: 0.86, 95% CI: (0.36, 2.05)]. Children who have mothers > 35 years of age were 78% less likely than children who had mothers younger than 25 years, Children who had mothers in secondary school and above were 77% less likely than mothers who didn't have formal education, Females were 1.86 times more likely than males, and Children who scored 20-29 on the Home score were 51% less likely than Children who scored < 20 to have fine motor delay. CONCLUSION Duration of breastfeeding was not significantly associated with fine motor delay for children aged 20 to 24 months old. The age of the mother, the educational status of the mother, being female, and Home score were identified to have a significant association with fine motor delay. Improving the educational status and empowerment of women is essential. Further work should be done on avoiding gender differences starting from a young age and creating a conducive environment for child development is crucial.
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Affiliation(s)
- Rediate Shiferaw
- Department of Reproductive Health and Nutrition, School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia.
| | - Robel Yirgu
- Department of nutrition and dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yalemwork Getnet
- Department of nutrition and dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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2
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Schaffer KE, Chambers CD, Garfein RS, Wertelecki W, Bandoli G. Breastfeeding and neurodevelopment in infants with prenatal alcohol exposure. Pediatr Res 2024; 95:819-826. [PMID: 37845525 DOI: 10.1038/s41390-023-02848-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Few studies have evaluated the differential benefits of breastfeeding on infant neurodevelopment at varying levels of prenatal alcohol exposure (PAE). This study examined whether the association between breastfeeding and neurodevelopment is modified by prenatal drinking pattern. METHODS The study included 385 infants from Ukraine born to women prospectively enrolled in a cohort study during pregnancy. Neurodevelopment was assessed at six and 12 months using the Bayley Scales of Infant Development II (BSID-II) Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI). Linear regression modeling with interaction terms and stratification by PAE group was used to determine the relationship between breastfeeding, PAE, and neurodevelopment. RESULTS A significant interaction between PAE and breastfeeding was observed for the MDI and PDI at six and 12 months. Infants with high PAE who were breastfed at least four months had BSID-II scores 14 or more points higher compared to those never breastfed. Counterintuitively, those with moderate PAE had poorer performance on the BSID-II at 12 months when breastfed longer. CONCLUSION There was a significant joint effect of PAE and breastfeeding on infant neurodevelopment at six and 12 months. Breastfeeding may provide distinct benefits to infants exposed to high levels of PAE. IMPACT We found a positive effect of breastfeeding on infant neurodevelopment among infants with prenatal alcohol exposure (PAE), particularly those exposed to higher levels during gestation. This study is one of the first to evaluate whether breastfeeding mitigates harm caused by PAE. Breastfeeding may provide distinct benefits to infants with higher levels of PAE.
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Affiliation(s)
- Kristen E Schaffer
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
| | - Christina D Chambers
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
| | - Richard S Garfein
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Wladimir Wertelecki
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
- Omni-Net for Children International Charitable Fund and Rivne Regional Medical Diagnostic Center, Rivne, Ukraine
- Omni-Net for Children International Charitable Fund and Khmelnytsky Perinatal Center, Khmelnytsky, Ukraine
| | - Gretchen Bandoli
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA.
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA.
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3
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Diongue O, Diouf A, Ndour PS, Badiane A, Thiam M, Faye MH, Sylla PM, Mama OM, Thiam EM, Dossou NI. Exclusive Breastfeeding Measured by Deuterium-Oxide Turnover Method is Associated with Motor Development in Rural Senegalese Infants. J Nutr 2023; 153:1850-1857. [PMID: 36792033 DOI: 10.1016/j.tjnut.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/14/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The findings on the relationship between breastfeeding and children's motor development are very poor, particularly in low and middle income countries, because of the use of inadequate measures of breastfeeding practices. OBJECTIVES To assess the relationship between exclusive breastfeeding, measured by the deuterium-oxide turnover method (DTM), and the acquisition of motor development in a cohort of Senegalese children. METHODS One hundred forty mother-infant (4-5 mo) pairs were recruited and monitored up to 18 mo. Breast milk intake and breastfeeding practices were measured by DTM. Six stages of motor development were assessed: "sitting without support," "hands-and-knees crawling," "standing with assistance," "walking with assistance," "standing alone," and "walking alone." Acquisition age of motor milestones between exclusively breastfed (EBF) and not exclusively breastfed (non-EBF) infants was compared using Student's and Wilcoxon's tests. Mixed linear regression, adjusted with confounding factors, was used to determine the association between EBF and motor development. RESULTS Overall, 32.9% of infants were EBF at the enrollment at 4-5 mo of age. Breast milk intake of EBF infants was significantly higher than that of non-EBF infants (1039 ± 193 g/d compared with 915 ± 211 g/d; P < 0.01). At 4-5 mo of age, only "sitting without support" (67.4% compared with 47.9%, P = 0.02) and "hands-and-knees crawling" (17.4% compared with 4.3%, P = 0.01) were completed significantly in the EBF group. At 18 mo, all children had completed all 6 motor developmental milestones. However, their acquisition age was significantly earlier in the EBF group after adjustment. Non-EBF infants had a delay of 0.4 to 0.5 mo on the acquisition of the first 5 stages compared to EBF infants. For "walking alone," no difference was found after adjustment. CONCLUSIONS Motor skill acquisition is earlier in EBF infants compared to non-EBF infants. This finding highlights the need to strengthen the advocacy for EBF up to 6 mo.
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Affiliation(s)
- Ousmane Diongue
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar-Fann, Sénégal.
| | - Adama Diouf
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar-Fann, Sénégal
| | - Pape S Ndour
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar-Fann, Sénégal
| | - Abdou Badiane
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar-Fann, Sénégal
| | - Mbeugué Thiam
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar-Fann, Sénégal
| | - Mane H Faye
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar-Fann, Sénégal
| | - Papa Mdd Sylla
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar-Fann, Sénégal
| | - Olouwafemi M Mama
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar-Fann, Sénégal
| | - ElHadji M Thiam
- Conseil National de Développement de la Nutrition, Rue 7 - Points E, Dakar, Sénégal
| | - Nicole I Dossou
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar-Fann, Sénégal
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4
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Breastfeeding is not a risk factor for clinical severity in Autism spectrum disorder in children from the ELENA cohort. Sci Rep 2023; 13:816. [PMID: 36646708 PMCID: PMC9842713 DOI: 10.1038/s41598-022-27040-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that results from a complex interaction between genes and environment. Breastfeeding (BF) is thought to promote healthy cognitive development, and a body of research has suggested that it may also protect against ASD. Our objectives were to identify the relationship between the initiation and duration of BF and the severity of clinical presentation in ASD. Data were collected from 243 children with a confirmed diagnosis of ASD followed in the ELENA cohort. Clinical severity was measured according to multiple dimensions using standardised tools. The frequency of the initiation of BF was comparable to that of the general population and the rate of children still being breastfed at six months of age was higher. Our results did not indicate a contribution of initiation or duration of BF to the prevention of clinical severity of ASD. We discuss our results in the light of possible methodological limitations of previous reports of an association between BF and ASD.Clinical Trial Registration: NCT02625116.
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5
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Gale-Grant O, Fenn-Moltu S, França LGS, Dimitrova R, Christiaens D, Cordero-Grande L, Chew A, Falconer S, Harper N, Price AN, Hutter J, Hughes E, O'Muircheartaigh J, Rutherford M, Counsell SJ, Rueckert D, Nosarti C, Hajnal JV, McAlonan G, Arichi T, Edwards AD, Batalle D. Effects of gestational age at birth on perinatal structural brain development in healthy term-born babies. Hum Brain Mapp 2022; 43:1577-1589. [PMID: 34897872 PMCID: PMC8886657 DOI: 10.1002/hbm.25743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/19/2021] [Accepted: 11/30/2021] [Indexed: 11/12/2022] Open
Abstract
Infants born in early term (37-38 weeks gestation) experience slower neurodevelopment than those born at full term (40-41 weeks gestation). While this could be due to higher perinatal morbidity, gestational age at birth may also have a direct effect on the brain. Here we characterise brain volume and white matter correlates of gestational age at birth in healthy term-born neonates and their relationship to later neurodevelopmental outcome using T2 and diffusion weighted MRI acquired in the neonatal period from a cohort (n = 454) of healthy babies born at term age (>37 weeks gestation) and scanned between 1 and 41 days after birth. Images were analysed using tensor-based morphometry and tract-based spatial statistics. Neurodevelopment was assessed at age 18 months using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Infants born earlier had higher relative ventricular volume and lower relative brain volume in the deep grey matter, cerebellum and brainstem. Earlier birth was also associated with lower fractional anisotropy, higher mean, axial, and radial diffusivity in major white matter tracts. Gestational age at birth was positively associated with all Bayley-III subscales at age 18 months. Regression models predicting outcome from gestational age at birth were significantly improved after adding neuroimaging features associated with gestational age at birth. This work adds to the body of evidence of the impact of early term birth and highlights the importance of considering the effect of gestational age at birth in future neuroimaging studies including term-born babies.
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Affiliation(s)
- Oliver Gale-Grant
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Sunniva Fenn-Moltu
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Lucas G S França
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Ralica Dimitrova
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Daan Christiaens
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid and CIBER-BBN, Madrid, Spain
| | - Andrew Chew
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Shona Falconer
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Nicholas Harper
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Anthony N Price
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Jana Hutter
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Emer Hughes
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Jonathan O'Muircheartaigh
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Mary Rutherford
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Serena J Counsell
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Daniel Rueckert
- Department of Computing, Imperial College London, London, UK.,Department of Medicine and Informatics, Technical University of Munich, Munich, Germany
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Grainne McAlonan
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,Paediatric Neurosciences, Evelina London Children's Hospital Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Bioengineering, Imperial College London, London, UK
| | - A David Edwards
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Dafnis Batalle
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
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6
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OUP accepted manuscript. Nutr Rev 2022; 80:1827-1835. [DOI: 10.1093/nutrit/nuac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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7
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Hou L, Li X, Yan P, Li Y, Wu Y, Yang Q, Shi X, Ge L, Yang K. Impact of the Duration of Breastfeeding on the Intelligence of Children: A Systematic Review with Network Meta-Analysis. Breastfeed Med 2021; 16:687-696. [PMID: 34077234 DOI: 10.1089/bfm.2020.0364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To evaluate the impact of the duration of breastfeeding on the intelligence of children. Materials and Methods: Eight electronic databases were searched to identify studies that investigated the impact of breastfeeding on the intelligence of children. Data were pooled, and the ratio of means (RoM) and the corresponding 95% confidence interval (95% CI) were calculated using a pairwise meta-analysis and network meta-analysis. Risk of bias was assessed using a tool developed by the CLARITY group. Data were analyzed using R version 3.5.1. Results: A total of 15 studies with 12,316 subjects were included in the review. Half of the studies were at low risk of bias. A meta-analysis indicated that breastfed children had a score 1.04-fold higher in intelligence tests compared with those that had never been breastfed (RoM: 1.04, 95% CI: 1.02-1.06, p < 0.05). Evidence from a network meta-analysis indicated that breastfeeding for ≤6 months resulted in score 1.04-fold higher in intelligence tests (RoM: 1.04, 95% CI: 1.03-1.06, p < 0.05) and children breastfed for >6 months had a score 1.06-fold higher (RoM: 1.06, 95% CI: 1.05-1.08, p < 0.05) than children that had never been breastfed. Thus, breastfeeding for >6 months demonstrated a slightly higher score than breastfeeding for ≤6 months (RoM: 1.02, 95% CI: 1.00-1.04, p < 0.05). Conclusion: Breastfeeding could significantly improve the intelligence of children, with a duration of >6 months showing a slight but significantly higher intelligence score than for ≤6 months.
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Affiliation(s)
- Liangying Hou
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xiuxia Li
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Peijing Yan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yanfei Li
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Yiting Wu
- The Zhongshan Affiliated Hospital, Fudan University, Shanghai, China
| | - Qingxia Yang
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiue Shi
- Institute for Evidence Based Rehabilitation Medicine of Gansu Province, Lanzhou, China
| | - Long Ge
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Kehu Yang
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.,Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
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8
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Sanefuji M, Senju A, Shimono M, Ogawa M, Sonoda Y, Torio M, Ichimiya Y, Suga R, Sakai Y, Honjo S, Kusuhara K, Ohga S. Breast feeding and infant development in a cohort with sibling pair analysis: the Japan Environment and Children's Study. BMJ Open 2021; 11:e043202. [PMID: 34380712 PMCID: PMC8359520 DOI: 10.1136/bmjopen-2020-043202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To investigate the association between breast feeding and infant development during the first year of life using sibling comparison. DESIGN Nationwide prospective birth cohort study with sibling pair analysis. SETTING 15 regional centres that participated in the Japan Environment and Children's Study. PARTICIPANTS This study included 77 119 children (singleton, term birth and no malformation/severe diseases) whose mothers were registered between January 2011 and March 2014, including 3521 duos or trios of siblings. PRIMARY OUTCOME MEASURES The primary outcome was developmental delay at 6 and 12 months of age, assessed using the Japanese translation of the Ages and Stages Questionnaires, third edition. Multivariable regression analyses adjusted for confounders were performed to estimate the risk ratios of delay associated with any or exclusive breast feeding. Pairs of siblings discordant for statuses were selected, and conditional regression analyses were conducted with a matched cohort design. RESULTS Developmental delay was identified in 6162 (8.4%) and 10 442 (14.6%) children at 6 and 12 months of age, respectively. Any breast feeding continued until 6 months or 12 months old was associated with reduced developmental delay at 12 months of age (adjusted risk ratio (95% CI): 0.81 (0.77 to 0.85) and 0.81 (0.78 to 0.84), respectively). Furthermore, exclusive breast feeding until 3 months was associated with reduced developmental delay at 12 months of age (adjusted risk ratio, 0.86 (95% CI 0.83 to 0.90)). In sibling pair analysis, the association between any breast feeding until 12 months and reduced developmental delay at 12 months of age persisted (adjusted risk ratio, 0.64 (95% CI 0.43 to 0.93)). CONCLUSIONS The present study demonstrated the association of continuous breast feeding with reduced developmental delay at 1 year of age using sibling pair analysis, in which unmeasured confounding factors are still present but less included. This may provide an argument to promote breastfeeding continuation.
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Affiliation(s)
- Masafumi Sanefuji
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ayako Senju
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masayuki Shimono
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masanobu Ogawa
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuri Sonoda
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Michiko Torio
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuko Ichimiya
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Reiko Suga
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yasunari Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Honjo
- Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan
| | - Koichi Kusuhara
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shouichi Ohga
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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9
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Bellando J, McCorkle G, Spray B, Sims CR, Badger TM, Casey PH, Scott H, Beall SR, Sorensen ST, Andres A. Developmental assessments during the first 5 years of life in infants fed breast milk, cow's milk formula, or soy formula. Food Sci Nutr 2020; 8:3469-3478. [PMID: 32724610 PMCID: PMC7382202 DOI: 10.1002/fsn3.1630] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/03/2020] [Accepted: 04/17/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To investigate the effects of infant feeding mode on childhood cognition and language as the differential effects of infant feeding on development remain understudied. METHODS Breastfed [BF, 174], cow's milk-based formula-fed [MF, 169], or soy protein-based formula-fed [SF, 161] children were longitudinally tested from age 3 to 60 months for neurodevelopment. Data were analyzed using mixed models while adjusting for multiple covariates. Sex differences were also assessed. RESULTS Standard scores were within established norms for all groups. There were no differences in mental development to age 24 months, yet BF children had significantly higher motor development scores at age 3 months than SF children (99.1 versus. 97.2). BF children had significantly higher composite intelligence scores at 48 months than MF and SF children (113.4 versus. 109.6 and 108.4, respectively) and higher verbal intelligence scores than SF children at 48 (105.6 versus. 100.7) and 60 months (109.8 versus. 105.9). Greater total language scores at ages 36 and 48 months were found in BF children compared with children fed MF or SF (p < .001), with differences between sexes for auditory comprehension. Higher total language scores at age 60 months were found between BF and SF (105.0 versus. 100.1). CONCLUSION Breastfeeding was associated with small, statistically significant, differences between children ages 3 and 5 years in verbal intelligence, expressive communication, and auditory comprehension with the latter having potential sexual dimorphic effects. Yet, these differences remain small and may not be of clinical relevance. Overall, MF and SF did not significantly differ.
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Affiliation(s)
- Jayne Bellando
- Arkansas Children's Nutrition CenterLittle RockARUSA
- Department of PediatricsUniversity of Arkansas for Medical SciencesLittle RockARUSA
| | | | - Beverly Spray
- Arkansas Children's Research InstituteLittle RockARUSA
| | - Clark R. Sims
- Arkansas Children's Nutrition CenterLittle RockARUSA
- Department of PediatricsUniversity of Arkansas for Medical SciencesLittle RockARUSA
| | - Thomas M. Badger
- Arkansas Children's Nutrition CenterLittle RockARUSA
- Department of PediatricsUniversity of Arkansas for Medical SciencesLittle RockARUSA
| | - Patrick H Casey
- Arkansas Children's Nutrition CenterLittle RockARUSA
- Department of PediatricsUniversity of Arkansas for Medical SciencesLittle RockARUSA
| | - Holly Scott
- Arkansas Children's Nutrition CenterLittle RockARUSA
| | | | - Seth T. Sorensen
- Arkansas Children's Nutrition CenterLittle RockARUSA
- Department of PediatricsUniversity of Arkansas for Medical SciencesLittle RockARUSA
| | - Aline Andres
- Arkansas Children's Nutrition CenterLittle RockARUSA
- Department of PediatricsUniversity of Arkansas for Medical SciencesLittle RockARUSA
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Rebelo M, Serrano J, Duarte-Mendes P, Paulo R, Marinho DA. Effect of Siblings and Type of Delivery on the Development of Motor Skills in the First 48 Months of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3864. [PMID: 32485909 PMCID: PMC7312057 DOI: 10.3390/ijerph17113864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/20/2020] [Accepted: 05/23/2020] [Indexed: 11/17/2022]
Abstract
This study aimed to verify whether the presence of siblings and the type of delivery had an influence on the motor skills development of children in the first 48 months of life. We developed a quantitative study with a sample of 405 children of both genders, divided according to the studied variables: children with siblings, children without siblings, children born via eutocic delivery, and children born via dystocic delivery. The instrument used in the study was the Peabody Developmental Motor Scales-2. Overall, the results indicated that children who had siblings had, on average, better outcomes regarding all motor skills (global and fine). Furthermore, those born via eutocic delivery, on average, had better outcomes regarding all motor skills (global and fine) when compared to children born via dystocic delivery. Thus, the presence of siblings in the family context and the type of delivery positively influenced motor development, especially after 24 months of age, showing that the presence of siblings providing cooperative activities through play and challenges improved cognitive, social, emotional, and physical development. Furthermore, a eutocic delivery, in addition to providing a better recovery from labor and the immediate affective bond between mother and child, also led to better results in terms of global and fine motor skills.
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Affiliation(s)
- Miguel Rebelo
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal;
- Department of Sports and Well-being Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (J.S.); (P.D.-M.); (R.P.)
| | - João Serrano
- Department of Sports and Well-being Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (J.S.); (P.D.-M.); (R.P.)
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal
| | - Pedro Duarte-Mendes
- Department of Sports and Well-being Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (J.S.); (P.D.-M.); (R.P.)
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal
| | - Rui Paulo
- Department of Sports and Well-being Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (J.S.); (P.D.-M.); (R.P.)
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal
| | - Daniel A. Marinho
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal;
- Research Centre in Sport Sciences, Health Sciences and Human Development (CIDESD), 6201-001 Covilhã, Portugal
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Walters DD, Phan LTH, Mathisen R. The cost of not breastfeeding: global results from a new tool. Health Policy Plan 2020; 34:407-417. [PMID: 31236559 PMCID: PMC6735804 DOI: 10.1093/heapol/czz050] [Citation(s) in RCA: 171] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2019] [Indexed: 11/16/2022] Open
Abstract
Evidence shows that breastfeeding has many health, human capital and future economic benefits for young children, their mothers and countries. The new Cost of Not Breastfeeding tool, based on open access data, was developed to help policy-makers and advocates have information on the estimated human and economic costs of not breastfeeding at the country, regional and global levels. The results of the analysis using the tool show that 595 379 childhood deaths (6 to 59 months) from diarrhoea and pneumonia each year can be attributed to not breastfeeding according to global recommendations from WHO and UNICEF. It also estimates that 974 956 cases of childhood obesity can be attributed to not breastfeeding according to recommendations each year. For women, breastfeeding is estimated to have the potential to prevent 98 243 deaths from breast and ovarian cancers as well as type II diabetes each year. This level of avoidable morbidity and mortality translates into global health system treatment costs of US$1.1 billion annually. The economic losses of premature child and women’s mortality are estimated to equal US$53.7 billion in future lost earnings each year. The largest component of economic losses, however, is the cognitive losses, which are estimated to equal US$285.4 billion annually. Aggregating these costs, the total global economic losses are estimated to be US$341.3 billion, or 0.70% of global gross national income. While the aim of the tool is to capture the majority of the costs, the estimates are likely to be conservative since economic costs of increased household caregiving time (mainly borne by women), and treatment costs related to other diseases attributable to not breastfeeding according to recommendations are not included in the analysis. This study illustrates the substantial costs of not breastfeeding, and potential economic benefits that could be generated by government and development partners’ investments in scaling up effective breastfeeding promotion and support strategies.
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Affiliation(s)
| | - Linh T H Phan
- Alive & Thrive, 60 Ly Thai To Street, Hoan Kiem, Ha Noi, Viet Nam
| | - Roger Mathisen
- Alive & Thrive, 60 Ly Thai To Street, Hoan Kiem, Ha Noi, Viet Nam
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12
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Rothstein JD, Caulfield LE, Broaddus ET, Muschelli J, Gilman RH, Winch PJ. "The doctor said formula would help me": Health sector influences on use of infant formula in peri-urban Lima, Peru. Soc Sci Med 2020; 244:112324. [PMID: 31189492 PMCID: PMC9818555 DOI: 10.1016/j.socscimed.2019.05.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 05/02/2019] [Accepted: 05/18/2019] [Indexed: 01/11/2023]
Affiliation(s)
- Jessica D. Rothstein
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, Maryland,Corresponding author, Jessica D. Rothstein, PhD, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W5515, Baltimore, MD 21231, , Phone: (617) 320-9395
| | - Laura E. Caulfield
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, Maryland
| | - Elena T. Broaddus
- University of Colorado, Department of Family Medicine, Denver, Colorado
| | - John Muschelli
- Johns Hopkins Bloomberg School of Public Health, Department of Biostatistics, Baltimore, Maryland
| | - Robert H. Gilman
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, Maryland,Universidad Peruana Cayetano Heredia, Laboratorio de Investigación en Enfermedades Infecciosas, Lima, Peru
| | - Peter J. Winch
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, Maryland
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13
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Tella P, Piccolo LDR, Rangel ML, Rohde LA, Polanczyk GV, Miguel EC, Grisi SJFE, Fleitlich-Bilyk B, Ferraro AA. Socioeconomic diversities and infant development at 6 to 9 months in a poverty area of São Paulo, Brazil. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2018; 40:232-240. [DOI: 10.1590/2237-6089-2017-0008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 01/08/2018] [Indexed: 11/22/2022]
Abstract
Abstract Introduction The effects of socioeconomic disparities on cognitive development tend to emerge early in infancy and to widen throughout childhood, and may perpetuate later in life. Although the study of how poverty affects early childhood has increased in the last 20 years, many of the effects remain largely unknown, especially during the first year of life. Aim To investigate the influence of socioeconomic status (SES) and maternal education on infants’ language, motor and cognitive development. Methods The cognitive, language and motor skills of 444 infants aged 6 to 9 months selected from a poor neighborhood in São Paulo, Brazil, were evaluated using the Bayley Scales of Infant Development. A questionnaire on socioeconomic background was administered to the participants’ families. Results A positive association was found between SES and infants’ performance on language and motor scales. Additionally, higher maternal education was associated with higher language and cognitive scores. Conclusion Our findings indicate that SES effects are detectable very early in infancy. This result has implications for the timing of both screening and intervention efforts to help children overcome the consequences of living in poverty.
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Affiliation(s)
- Patricia Tella
- Universidade de São Paulo, Brazil; Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, Brazil
| | | | | | - Luis Augusto Rohde
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
| | | | | | | | - Bacy Fleitlich-Bilyk
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, Brazil; USP, Brazil
| | - Alexandre Archanjo Ferraro
- Universidade de São Paulo, Brazil; Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, Brazil
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14
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Michels KA, Ghassabian A, Mumford SL, Sundaram R, Bell EM, Bello SC, Yeung EH. Breastfeeding and motor development in term and preterm infants in a longitudinal US cohort. Am J Clin Nutr 2017; 106:1456-1462. [PMID: 29092884 PMCID: PMC5698835 DOI: 10.3945/ajcn.116.144279] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 10/05/2017] [Indexed: 12/21/2022] Open
Abstract
Background: The relation between breastfeeding and early motor development is difficult to characterize because of the problems in existing studies such as incomplete control for confounding, retrospective assessment of infant feeding, and even the assessment of some motor skills too early.Objective: We sought to estimate associations between infant feeding and time to achieve major motor milestones in a US cohort.Design: The Upstate New York Infant Development Screening Program (Upstate KIDS Study) enrolled mothers who delivered live births in New York (2008-2010). Mothers of 4270 infants (boys: 51.7%) reported infant motor development at 4, 8, 12, 18, and 24 mo postpartum; information on infant feeding was reported at 4 mo. Accelerated failure time models were used to compare times to standing or walking across feeding categories while adjusting for parental characteristics, daycare, region, and infant plurality, sex, rapid weight gain, and baseline neurodevelopmental test results. Main models were stratified by preterm birth status.Results: The prevalence of exclusive breastfeeding in preterm infants was lower than in term infants at 4 mo postpartum (8% compared with 19%). After adjustment for confounders, term infants who were fed solids in addition to breast milk at 4 mo postpartum achieved both standing [acceleration factor (AF): 0.93; 95% CI: 0.87, 0.99] and walking (AF: 0.93; 95% CI: 0.88, 0.98) 7% faster than did infants who were exclusively breastfed, but these findings did not remain statistically significant after correction for multiple testing. We did not identify feeding-associated differences in motor milestone achievement in preterm infants.Conclusion: Our results suggest that differences in feeding likely do not translate into large changes in motor development. The Upstate KIDS Study was registered at clinicaltrials.gov as NCT03106493.
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Affiliation(s)
- Kara A Michels
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Akhgar Ghassabian
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Sunni L Mumford
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Rajeshwari Sundaram
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Erin M Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health, Rensselaer, NY; and
| | | | - Edwina H Yeung
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD;
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15
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Nutrition (Micronutrients) in Child Growth and Development: A Systematic Review on Current Evidence, Recommendations and Opportunities for Further Research. J Dev Behav Pediatr 2017; 38:665-679. [PMID: 28746059 DOI: 10.1097/dbp.0000000000000482] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE An important aspect of malnutrition is deficiency of different micronutrients during pregnancy or early childhood. We systematically reviewed the role of nutrition in child growth (weight or height gain) and development. METHODS A comprehensive literature search was done on PubMed/Cochrane Library browsing through 38,795 abstracts until December 31, 2016 to select systematic reviews/meta-analyses and individual randomized controlled trials (RCTs) of micronutrient supplementation. RESULTS Micronutrients studied included iron, iodine, folate, zinc, calcium, magnesium, selenium, vitamin D, vitamin A, vitamin B complex, and multiple micronutrients. We summarize evidence with details and results of RCTs, highlight strengths/weaknesses, and critically interpret findings. Effects of breastfeeding-promotion, food-supplementation (complementary and school feeding), conditional-cash-transfers, and integrated nutrition/psychosocial interventions are discussed. CONCLUSION Based on this evidence we make policy and programmatic recommendations for supplementation to mothers and children at high-risk of deficiency.
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16
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Pereira KR, Valentini NC, Saccani R. Brazilian infant motor and cognitive development: Longitudinal influence of risk factors. Pediatr Int 2016; 58:1297-1306. [PMID: 27084989 DOI: 10.1111/ped.13021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 04/08/2016] [Accepted: 04/13/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Infant developmental delays have been associated with several risk factors, such as familial environmental, individual and demographic characteristics. The goal of this study was to longitudinally investigate the effects of maternal knowledge and practices, home environment and biological factors on infant motor and cognitive outcomes. METHODS This was a prospective cohort study with a sample of 49 infants from Southern Brazil. The infants were assessed three times over 4 months using the Alberta Infant Motor Scale and the Bayley Scale of Infant Development (Mental Development Scale). Parents completed the Daily Activities Scale of Infants, the Affordances in The Home Environment for Motor Development - Infant Scale, the Knowledge of Infant Development Inventory and a demographic questionnaire. Generalized estimating equation with Bonferroni method as the follow-up test and Spearman correlation and multivariate linear backward regression were used. RESULTS Cognitive and motor scores were strongly associated longitudinally and increased over time. Associations between the home affordances, parental practices and knowledge, and motor and cognitive development over time were observed. This relationship explained more variability in motor and cognitive scores compared with biological factors. CONCLUSIONS Variability in motor and cognitive development is better explained by environment and parental knowledge and practice. The investigation of factors associated with infant development allows the identification of infants at risk and the implementation of educational programs and parental training to minimize the effects of developmental delay.
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Affiliation(s)
- Keila Rg Pereira
- School of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Nadia C Valentini
- School of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Raquel Saccani
- School of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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17
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Pereira KRG, Saccani R, Valentini NC. Cognição e ambiente são preditores do desenvolvimento motor de bebês ao longo do tempo. FISIOTERAPIA E PESQUISA 2016. [DOI: 10.1590/1809-2950/14685223012016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Investigou-se longitudinalmente relações entre desenvolvimento motor e cognitivo, aspectos biológicos, práticas maternas, conhecimento parental e ambiente familiar de bebês. Participaram do estudo 49 bebês (3-16 meses) avaliados com a Alberta Infant Motor Scale e a Escala Mental da Bayley Scale of Infant Development. Os pais responderam o questionário sobre fatores biológicos, Daily Activities of Infant Scale, o Affordances no Ambiente Domiciliar para o Desenvolvimento Motor - Escala Bebê, e o Inventário sobre Conhecimento do Desenvolvimento Infantil. Avaliações foram conduzidas nas escolas ao longo de 4 meses. Foram utilizadas Equações de Estimativa Generalizada, teste de Bonferroni e coeficiente de correlação de Spearman. Observaram-se associações significativas na (1) análise univariada entre desenvolvimento motor e cognitivo e fatores ambientais (escolaridade, renda, disponibilidade de brinquedos, espaço físico, práticas e conhecimento parental, tempo de aleitamento e frequência na escola); (2) multivariada entre o desenvolvimento motor e renda, idade do pai e espaço físico da residência. Concluiu-se que os desenvolvimentos motores e cognitivos se mostraram interdependentes e fatores ambientais se mostraram mais significativos nas associações em detrimento dos biológicos, reforçando-se a importância do lar, do cuidado dos pais e das experiências que a criança vivencia ao longo dos primeiros anos de vida.
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18
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Abstract
AIM This study was aimed at systematically reviewing evidence of the association between breastfeeding and performance in intelligence tests. METHODS Two independent searches were carried out using Medline, LILACS, SCIELO and Web of Science. Studies restricted to infants and those where estimates were not adjusted for stimulation or interaction at home were excluded. Fixed- and random-effects models were used to pool the effect estimates, and a random-effects regression was used to assess potential sources of heterogeneity. RESULTS We included 17 studies with 18 estimates of the relationship between breastfeeding and performance in intelligence tests. In a random-effects model, breastfed subjects achieved a higher IQ [mean difference: 3.44 points (95% confidence interval: 2.30; 4.58)]. We found no evidence of publication bias. Studies that controlled for maternal IQ showed a smaller benefit from breastfeeding [mean difference 2.62 points (95% confidence interval: 1.25; 3.98)]. In the meta-regression, none of the study characteristics explained the heterogeneity among the studies. CONCLUSION Breastfeeding is related to improved performance in intelligence tests. A positive effect of breastfeeding on cognition was also observed in a randomised trial. This suggests that the association is causal.
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Affiliation(s)
- Bernardo L Horta
- Postgraduate Program in Epidemiology; Universidade Federal de Pelotas; Pelotas Brazil
| | | | - Cesar G Victora
- Postgraduate Program in Epidemiology; Universidade Federal de Pelotas; Pelotas Brazil
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19
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Cai S, Pang WW, Low YL, Sim LW, Sam SC, Bruntraeger MB, Wong EQ, Fok D, Broekman BFP, Singh L, Richmond J, Agarwal P, Qiu A, Saw SM, Yap F, Godfrey KM, Gluckman PD, Chong YS, Meaney MJ, Kramer MS, Rifkin-Graboi A. Infant feeding effects on early neurocognitive development in Asian children. Am J Clin Nutr 2015; 101:326-36. [PMID: 25646330 DOI: 10.3945/ajcn.114.095414] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Breastfeeding has been shown to enhance global measures of intelligence in children. However, few studies have examined associations between breastfeeding and specific cognitive task performance in the first 2 y of life, particularly in an Asian population. OBJECTIVE We assessed associations between early infant feeding and detailed measures of cognitive development in the first 2 y of life in healthy Asian children born at term. DESIGN In a prospective cohort study, neurocognitive testing was performed in 408 healthy children (aged 6, 18, and 24 mo) from uncomplicated pregnancies (i.e., birth weight >2500 and <4000 g, gestational age ≥37 wk, and 5-min Apgar score ≥9). Tests included memory (deferred imitation, relational binding, habituation) and attention tasks (visual expectation, auditory oddball) as well as the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Children were stratified into 3 groups (low, intermediate, and high) on the basis of breastfeeding duration and exclusivity. RESULTS After potential confounding variables were controlled for, significant associations and dose-response relations were observed for 4 of the 15 tests. Higher breastfeeding exposure was associated with better memory at 6 mo, demonstrated by greater preferential looking toward correctly matched items during early portions of a relational memory task (i.e., relational binding task: P-trend = 0.015 and 0.050 for the first two 1000-ms time bins, respectively). No effects of breastfeeding were observed at 18 mo. At 24 mo, breastfed children were more likely to display sequential memory during a deferred imitation memory task (P-trend = 0.048), and toddlers with more exposure to breastfeeding scored higher in receptive language [+0.93 (0.23, 1.63) and +1.08 (0.10, 2.07) for intermediate- and high-breastfeeding groups, respectively, compared with the low-breastfeeding group], as well as expressive language [+0.58 (-0.06, 1.23) and +1.22 (0.32, 2.12) for intermediate- and high-breastfeeding groups, respectively] assessed via the BSID-III. CONCLUSIONS Our findings suggest small but significant benefits of breastfeeding for some aspects of memory and language development in the first 2 y of life, with significant improvements in only 4 of 15 indicators. Whether the implicated processes confer developmental advantages is unknown and represents an important area for future research. This trial was registered at www.clinicaltrials.gov as NCT01174875.
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Affiliation(s)
- Shirong Cai
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Wei Wei Pang
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Yen Ling Low
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Lit Wee Sim
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Suet Chian Sam
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Michaela Bianka Bruntraeger
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Eric Qinlong Wong
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Doris Fok
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Birit F P Broekman
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Leher Singh
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Jenny Richmond
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Pratibha Agarwal
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Anqi Qiu
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Seang Mei Saw
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Fabian Yap
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Keith M Godfrey
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Peter D Gluckman
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Yap-Seng Chong
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Michael J Meaney
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Michael S Kramer
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
| | - Anne Rifkin-Graboi
- From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada
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Golding J, Emmett P, Iles-Caven Y, Steer C, Lingam R. A review of environmental contributions to childhood motor skills. J Child Neurol 2014; 29:1531-47. [PMID: 24170258 PMCID: PMC4004720 DOI: 10.1177/0883073813507483] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Although much of children's motor skills have a heredity component, at least half of the variance is likely to be influenced by the environment. It is important to ascertain features of the environment that are responsible so that toxins can be avoided, children at risk can be identified, and beneficial interventions initiated. This review outlines the results of published studies and recommends the areas where further research is required. We found much confusion with little comparability concerning the ages or measures used. Few studies had sufficient power and few allowed for confounders. We found that research to date implicates associations with prenatal drinking ≥4 drinks of alcohol per day; diabetes; taking antidepressant drugs; being deficient in iodine or iron; dietary fish; and postnatal depression. The child appearing to be most at risk was born of low birth weight (but not due to preterm delivery) or with neonatal problems.
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Affiliation(s)
- Jean Golding
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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21
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Breastfeeding and behavioral development: a nationwide longitudinal survey in Japan. J Pediatr 2014; 164:1019-1025.e3. [PMID: 24529622 DOI: 10.1016/j.jpeds.2014.01.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 12/10/2013] [Accepted: 01/07/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To prospectively examine the prolonged effect of breastfeeding on behavioral development. STUDY DESIGN We used a large, nationwide Japanese population-based longitudinal survey that began in 2001. We restricted participants to term singletons with birth weight >2500 g (n = 41 188). Infant feeding practice was queried at age 6-7 months. Responses to survey questions about age-appropriate behaviors at age 2.5 and 5.5 years were used as indicators of behavioral development. We conducted logistic regression analyses, controlling for potential child and parental confounding factors, with formula feeding as the reference group. RESULTS We observed a dose-response relationship between breastfeeding status and an inability to perform age-appropriate behaviors at both ages. With a single exception, all ORs for outcomes for exclusive breastfeeding were smaller than those for partial feeding of various durations. The protective associations did not change after adjustment for an extensive list of confounders or in the sensitivity analyses. CONCLUSION We observed prolonged protective effects of breastfeeding on developmental behavior skills surveyed at age 2.5 and 5.5 years. Beneficial effects were most likely in children who were breastfed exclusively, but whether a biological ingredient in breast milk or extensive interactions through breastfeeding, or both, is beneficial is unclear.
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22
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Hayashida K, Nakatsuka M. Promoting factors of physical and mental development in early infancy: a comparison of preterm delivery/low birth weight infants and term infants. Environ Health Prev Med 2013; 19:160-71. [PMID: 24288172 DOI: 10.1007/s12199-013-0370-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 11/01/2013] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess correlations between various factors and the physical and mental development of 4-month-old infants using a multi-faceted evaluation approach. METHODS A total of 1,402 self-administered questionnaires were distributed to consenting mothers of infants who had undergone a 4-month health checkup in Hiroshima prefecture, Japan. The questionnaires included items from the Japan Child and Family Research Institute Child Rearing Support Questionnaire and the KIDS type A test. Of the 421 completed questionnaires on mother-child pairs that were returned, 318 met the inclusion criteria and were eligible for further analysis. RESULTS Comparison between infants in a preterm delivery or low birth weight (LBW) group (preterm and/or LBW group; n = 31) and a term delivery appropriate-weight for date (AFD) infant group (term AFD group; n =287) revealed that the preterm and/or LBW group had significantly higher mother child-rearing anxiety and difficult baby scores, along with significantly lower infant development and motor skill scores. Within the term AFD group, infants of primiparous mothers had significantly higher scores for motor skill and sociability with adults than those of multiparous mothers. Language comprehension scores were significantly higher in infants that were exclusively breast-fed than those formula-fed or combined breast-fed and formula-fed. Verbalization scores of infants whose mothers worked were significantly higher than those of infants whose mothers did not work. Infants with siblings aged <4 years exhibited significantly lower scores for motor skills, verbalization, and sociability with adults than infants without siblings or with siblings aged at least 5 years. In particular, we found that a mother's child-rearing anxiety was related to many areas of infant development. CONCLUSIONS Evaluating the absence or presence of such factors and conducting preventive treatment could promote healthy infant development.
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Affiliation(s)
- Kaori Hayashida
- Graduate School of Health Sciences, Okayama University, 2-5-1 Shikata, Kita-ku, Okayama, Okayama, 700-8558, Japan,
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23
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Walfisch A, Sermer C, Cressman A, Koren G. Breast milk and cognitive development--the role of confounders: a systematic review. BMJ Open 2013; 3:e003259. [PMID: 23975102 PMCID: PMC3753522 DOI: 10.1136/bmjopen-2013-003259] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The association between breastfeeding and child cognitive development is conflicted by studies reporting positive and null effects. This relationship may be confounded by factors associated with breastfeeding, specifically maternal socioeconomic class and IQ. DESIGN Systematic review of the literature. SETTING AND PARTICIPANTS Any prospective or retrospective study, in any language, evaluating the association between breastfeeding and cognitive development using a validated method in healthy term infants, children or adults, was included. PRIMARY AND SECONDARY OUTCOME MEASURES Extracted data included the study design, target population and sample size, breastfeeding exposure, cognitive development assessment tool used and participants' age, summary of the results prior to, and following, adjustment for confounders, and all confounders adjusted for. Study quality was assessed as well. RESULTS 84 studies met our inclusion criteria (34 rated as high quality, 26 moderate and 24 low quality). Critical assessment of accepted studies revealed the following associations: 21 null, 28 positive, 18 null after adjusting for confounders and 17 positive-diminished after adjusting for confounders. Directionality of effect did not correlate with study quality; however, studies showing a decreased effect after multivariate analysis were of superior quality compared with other study groupings (14/17 high quality, 82%). Further, studies that showed null or diminished effect after multivariate analysis corrected for significantly more confounders (7.7±3.4) as compared with those that found no change following adjustment (5.6±4.5, p=0.04). The majority of included studies were carried out during childhood (75%) and set in high-income countries (85.5%). CONCLUSIONS Much of the reported effect of breastfeeding on child neurodevelopment is due to confounding. It is unlikely that additional work will change the current synthesis. Future studies should attempt to rigorously control for all important confounders. Alternatively, study designs using sibling cohorts discordant for breastfeeding may yield more robust conclusions.
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Affiliation(s)
- Asnat Walfisch
- The Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics and Pharmacology, University of Toronto, Toronto, Ontario, Canada
| | - Corey Sermer
- University of Western Ontario, London, Ontario, Canada
| | - Alex Cressman
- The Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics and Pharmacology, University of Toronto, Toronto, Ontario, Canada
| | - Gideon Koren
- The Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics and Pharmacology, University of Toronto, Toronto, Ontario, Canada
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Lung FW, Shu BC, Chiang TL, Lin SJ. Maternal mental health and childrearing context in the development of children at 6, 18 and 36 months: a Taiwan birth cohort pilot study. Child Care Health Dev 2011; 37:211-23. [PMID: 21083687 DOI: 10.1111/j.1365-2214.2010.01163.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study investigated a possible pathway of the childrearing context and maternal mental health at 6 months, and how these factors influence children's development at 6, 18 and 36 months. METHODS Using random sampling, 2048 children and mothers were selected. The mother's health status was evaluated using the Taiwanese version of the 36-Item Short Form Health Survey (SF-36), and infant development was assessed using the high reliable Taiwan birth cohort study instrument. All data were collected using parental self-report, and were analysed using multiple linear regression analysis and further pathway using structural equation modelling. RESULTS This study showed that 12 factors effected children's development at 6 months, and some dissipated with growth. Of these, maternal education had an enduring effect on different domains of child development, and this effect intensified as the child grew older. Children who grew up in a family with more siblings would show a delay in language development at 6 months; they have a delay in motor and social development at 18 and 36 months. Additionally, maternal mental health effected the children's fine motor development at 6 months. However, this effect disappeared at 18 months, and influenced children's social development at 36 months. CONCLUSIONS This study demonstrated that the development of children at as young as 6 months is affected by various factors. These factors may dissipate, continue to influence child development up to 3 years of age, turn from being disadvantageous to beneficial, or affect different domains of child development. Also, parental self-report instrument might be has its limitation and could be contributed by several confounding factors. Thus, continuous longitudinal follow-up on changes in maternal conditions, family factors, and environmental factors is vital to understand how these early infantile factors affect each other and influence the developmental trajectories of children into early childhood.
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Affiliation(s)
- F-W Lung
- Department of Medicine, Kaohsiung Armed Forces General Hospital, Department of Neurology, Kaohsiung Medical University, Kaohsiung, Taiwan
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Infant overweight is associated with delayed motor development. J Pediatr 2010; 157:20-25.e1. [PMID: 20227724 PMCID: PMC3395373 DOI: 10.1016/j.jpeds.2009.12.054] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Revised: 11/17/2009] [Accepted: 12/30/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine how infant overweight and high subcutaneous fat relate to infant motor development. STUDY DESIGN Participants were from the Infant Care, Feeding, and Risk of Obesity Project, a prospective, longitudinal study of low-income African-American mother-infant dyads assessed from 3 to 18 months of age (836 observations on 217 infants). Exposures were overweight (weight-for-length z-score>or=90th percentile of 2000 Centers for Disease Control/National Center for Health Statistics growth reference) and high subcutaneous fat (sum of 3 skinfold measurements>90th percentile of our sample). Motor development was assessed by using the Bayley Scales of Infant Development-II. Developmental delay was characterized as a standardized Psychomotor Development Index score<85. Longitudinal models estimated developmental outcomes as functions of time-varying overweight and subcutaneous fat, controlling for age and sex. Alternate models tested concurrent and lagged relationships (earlier weight or subcutaneous fat predicting current motor development). RESULTS Motor delay was 1.80 times as likely in overweight infants compared with non-overweight infants (95% CI,1.09-2.97) and 2.32 times as likely in infants with high subcutaneous fat compared with infants with lower subcutaneous fat (95% CI, 1.26-4.29). High subcutaneous fat was also associated with delay in subsequent motor development (odds ratio, 2.27; 95% CI, 1.08-4.76). CONCLUSIONS Pediatric overweight and high subcutaneous fat are associated with delayed infant motor development.
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Caminha MDFC, Batista Filho M, Serva VB, Arruda IKGD, Figueiroa JN, Lira PICD. Tendências temporais e fatores associados à duração do aleitamento materno em Pernambuco. Rev Saude Publica 2010; 44:240-8. [DOI: 10.1590/s0034-89102010000200003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Accepted: 10/26/2009] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Analisar as tendências temporais de duração do aleitamento materno exclusivo e os fatores de proteção. MÉTODOS: Foram analisadas as prevalências de amamentação total e o aleitamento materno exclusivo de lactentes aos quatro meses de idade. Os dados foram obtidos de inquéritos populacionais realizados em 1991, 1997 e 2006, com 935, 2.081 e 1.568 crianças, respectivamente. Os dados foram coletados por entrevista realizada com o responsável pela criança. As prevalências foram analisadas por regressão de Poisson em relação a: condições ambientais, comportamentais e socioeconômicas, variáveis maternas e fatores biológicos da criança. RESULTADOS: A duração mediana do aleitamento total elevou-se de 89 dias (1991) para 106 dias (1997) e, finalmente, 183 dias (2006). A mediana do aleitamento materno exclusivo manteve-se estacionária em torno de 30 dias entre 1997 e 2006. Na análise multivariada, das dez variáveis analisadas, apenas a escolaridade e idade maternas, situação do domicílio e a criança ser do sexo feminino se mantiveram no modelo explicativo final. CONCLUSÕES: Apesar do aleitamento total ter tido importante aumento de duração, o mesmo não ocorreu com a duração do aleitamento materno exclusivo.
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Caminha MDFC, Serva VB, Arruda IKGD, Batista Filho M. Aspectos históricos, científicos, socioeconômicos e institucionais do aleitamento materno. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2010. [DOI: 10.1590/s1519-38292010000100003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
As fontes bibliográficas pesquisadas para esta revisão foram artigos publicados em revistas científicas indexadas, livros, documentos da Organização Mundial da Saúde, Ministério da Saúde e relatórios estaduais e nacionais relacionados à prevalência e medidas de promoção do aleitamento materno. Foi utilizada a base de dados PubMed abrangendo o período de 1952 a 2008. Outros artigos foram identificados em decorrência de citações bibliográficas nas fontes de informações previamente consultadas. Esta pesquisa abrangeu os aspectos históricos relacionados ao aleitamento materno, as evidências científicas de efeitos a curto e longo prazos, fatores associados, modalidades, duração e prevalência do aleitamento materno. Concluiu-se que, apesar da importância amplamente reconhecida dessa prática para mãe, filho, família, comunidade e Estado, e de todas as ações realizadas para promoção, proteção e apoio ao aleitamento materno, os resultados demonstraram que o cumprimento das metas e recomendações internacionais ainda denotam situações insatisfatórias.
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Torres AG, Trugo NMF. Evidence of inadequate docosahexaenoic acid status in Brazilian pregnant and lactating women. Rev Saude Publica 2009; 43:359-68. [PMID: 19287877 DOI: 10.1590/s0034-89102009000200018] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Accepted: 09/12/2008] [Indexed: 11/22/2022] Open
Abstract
Recently published data concerning dietary intake of fat and food sources of (n-3) long-chain polyunsaturated fatty acids (LCPUFA) in Brazil are reviewed together with data on biochemical indices of PUFA status during pregnancy and lactation and PUFA composition of breast milk in Brazilian adolescents and adults. Potential inadequacies of docosahexaenoic acid (DHA) status among Brazilian pregnant and lactating women have not yet been thoroughly evaluated. The data reviewed show that dietary intake of food sources of n-3 LCPUFA is low and possibly deficient in Brazil, and that biochemical indices of maternal DHA status and breast milk DHA content are low compared to the international literature. These data indicate inadequate DHA status among Brazilian women during pregnancy and lactation, but this evidence needs confirmation through comprehensive and specific population-based studies.
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Affiliation(s)
- Alexandre G Torres
- Laboratório de Bioquímica Nutricional e de Alimentos, Instituto de Química, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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